A Sigh Breath: More Than A Metaphor

It’s been a thunderous week. I’ve swept through emotions like a teenager. People who know me, know what these weeks look like. Not unstable, just exuberant.

I consider my emotions a strength. I know they help me empathize and advocate for my patients. I count on my ability to feel and connect with others to define and paint my life’s landscape. Without this raw, and sometimes outrageous emotion, I wouldn’t be happy and I wouldn’t be able to care for my patients and my family like I do.

So a week all over the map. Mountain ranges of emotion peaked between panic, hope, celebration, connection, distance, activation, and then plain old, tired. Feeling celebrated and understood by my peers (thank you), and then alone in caring for children in clinic. It can feel so good to see patients. I’m so fortunate to be able to solve problems and answer questions. But then, it can be isolating somehow, too. Being singularly responsible for answers at times is something I am well trained to do. But it doesn’t always leave me feeling whole.

I am really feeling though. And life feels good in these spots, despite the hyperbole and tears, great accomplishment and grin. And although the air I’m breathing feels bumpy when it enters my lungs, I like this life. As I let out a huge sigh while sitting at the computer just now, I was reminded of the function of sighing.

I’m not supposed to be writing this. But all of the sudden I had to. This afternoon, I set out (and am halfway through) another post about kids dying after being left in hot, locked cars. It’s tragic and heavy but very worth writing about. As I was writing (and subsequently reeling), I realized what I really needed to do was to take a big sigh. You know, the kind where you fill your entire chest with air to the point where you feel the elastic on your bra strap draw a line around your chestwall, and then you exhale loudly. The kind of breath your mother took when she was disappointed in you. Or really, the kind you take when no one is looking and you’ve just discovered where you are. The breath that can provide a space between two moments in time. Or space like when you’re writing and you hit the return key.

Ever since I did my first rotation through the pediatric intensive care unit (PICU) during my second year of residency, the word *sigh* has meant something entirely different. I used to think of a sigh as a sign of fatigue, exacerbation, frustration. Or a break, like I said above. But a pulmonary physiologist would say these breaths are normal and necessary. Children and adults tend to take a sigh breath about 6-8 times an hour, naturally. As if life is supposed to throw challenges at us so we step back, take a deep breath, and break up the day. Do we need these mountains of feeling so that we fill up, clear out, and expand out lungs periodically? Maybe.

In the PICU one day, I learned that when an older child is on a ventilator and the machine is pushing air in through a breathing tube and then letting air rush out every few seconds, it needs to provide a sigh. Otherwise the child may be more prone to developing a pneumonia. So the ventilator is programmed to deliver about 1 1/2 times the normal volume of air every 10 minutes or so to re-create a sigh. As a child is then delivered the sigh, they open up, clear out, and expand their lungs.

I remember standing in the room of a critically ill patient when the PICU attending explained this to me and we watched the patient take a calculated sigh breath. I remember feeling relieved on some level. Thinking maybe the patient had just been given a little extra moment to heal, recover, and connect. To find space to capture the courage to move on in fighting devastating illness.

Sometimes when I sigh, like I just did this afternoon, I think about those children I met in the PICU. And that’s when I really regain perspective about luck and my ridiculous good fortune in life. This perspective keeps me fueled to learn about and share news that can help us all prevent, eliminate, and cure pediatric illness and injury. So one more sigh, and I’m back to that post.

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3 Comments to “A Sigh Breath: More Than A Metaphor”

So right there with you mamadoc! Just sighed about 4 times while reading this article and feel better already, despite the endless to do list, the febrile son, the sick patients in the hospital… tears are good… sighs are good too- and feel healthy. Good health to you and your loved ones. Thanks for reminding us to breathe.

I needed to read this blog this morning. It was most definetly sigh inducing, which at times all of us need to simply be reminded to breathe through life as it happens. Thanks again for the great blogs!

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Seattle Children’s provides healthcare for the special needs of children regardless of race, color, creed, national origin, religion, sex (gender), sexual orientation or disability. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is in Washington, Alaska, Montana or Idaho.